Psychiatric evaluation (first visit)
Facility: Bob Wilson Memorial Hospital
Billing Code: 90791 (CPT)
- CPT Billing Code: 90791
- Insurance Median: $226
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.25x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $181.34 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $226 | 125% |
Consumer Guidance & Cost Commentary
For this psychiatric evaluation at Bob Wilson Memorial Hospital in Ulysses, Kansas, the negotiated rate is $226.00, which is 20% higher than the Medicare benchmark of $181.34. While this facility is a Critical Access Hospital owned by a voluntary non-profit church, there is no available cash or median paid data to compare against state or county averages. Because commercial negotiated rates often include administrative overhead and contract premiums, patients should verify if their specific insurance plan allows for a lower allowed amount before scheduling. It is important to note that cash-pay options may sometimes be more cost-effective for those with high-deductible plans if the negotiated rate exceeds the cash price, though current data does not confirm a specific cash rate for this service.
To minimize potential costs, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can range from 20% to 50% off the billed amount when paid in full upfront. These discounts bypass the administrative costs associated with insurance claims processing and provide immediate liquidity to the facility. If you are concerned about balance billing, remember that the No Surprises Act protects you from being billed for out-of-network services at in-network facilities, but you should still request a full itemized bill to ensure no unbundled codes or services not rendered are included. Always check your deductible status before using insurance, as paying out-of-pocket without meeting your deductible could result in higher out-of-pocket expenses than expected.